Diversification Key to Avoiding Professional Boredom

Let's face it; after a while, medicine can become routine. Most women have similar complaints, and most of the remedies are the same. From time to time, we'll encounter a challenging case that really takes thought and creativity, but usually not. So how do we stay engaged? Diversify!

I've struggled with this for a while. When I was in a large hospital setting, I had a full-scope practice, was on call a lot, taught residents and medical students, fought the bureaucracy, and tried to find my niche. After 8 years, I no longer wanted to be in a large institution and set out on my own. The first 5 years of private practice were fascinating. I had to restrict dramatically my scope of practice because of the cost of malpractice insurance in New York. I no longer taught, delivered babies, or did surgery. However, I learned so much about business in those early years that I didn't really mind the monotony of the patient care in the office. Further, the intellectual blandness of the medicine practiced was more than offset by the opportunity to spend more time with my patients and really get to know them in a way that had never been possible in a busy clinic.

Nine-plus years into private practice, I have learned everything I'm going to learn about running a small business. I built it from scratch, and I did so successfully. But for the past 2 years, I've been utterly miserable. It took a while for me to figure out why I was unhappy. I had built a solid practice from the ground up. I enjoy my patients. I have a wonderful staff. But the challenge was missing.

As I considered the rut I was in, I realized that I would never make it another 20 years as a physician if something didn't change. I spoke to many friends in other fields of medicine and realized that we were all feeling the same way. It was sad to realize that my generation of doctors was feeling stifled and uninspired. As I considered my options, they were rather overwhelming. I could go back to school for an MBA or MPH; I could get training in acupuncture or integrative health; I could do a fellowship; I could expand the office to the next level with multiple locations-the list was endless. After a year of mulling over possible career changes, I realized that what I missed most was public service and teaching. 

I went into medicine to do public health. My transition to private practice was really a practical necessity for my family but had never been an aspiration. Yet, the personal freedom it affords is not to be taken for granted. As I searched for an outlet for my desire for public service, the 2010 Haitian Earthquake happened. As a native French speaker who had worked in Francophone Africa, the opportunity to go to Haiti was perfect in its scope and timing. I went, “fell in love" with the work and the people, and have returned twice a year since then.

But, it wasn't enough. The high I got from going to Haiti didn't sustain me through the other 50 weeks a year. I decided to pursue teaching. I have had several nurse practitioners in my practice from the Columbia University School of Nursing and had gotten to know the head of the program. I approached her about teaching some classes and became an invited speaker for several class sessions.

Around the same time, I had the opportunity to expand my work with Physicians for Human Rights, with whom I had worked for years providing medical affidavits to victims of female genital mutilation (FGM) seeking asylum. I began doing lectures, expanded my case load, and ultimately joined the Human Rights Clinic at Mt. Sinai

So now my plate is spilling over. I have much more work, I sleep less, I cram way more into every day, but I'm so much happier. I feel challenged, worthwhile as a physician, and more satisfied with my life. For the first time in years, I can imagine the next 20 years of my professional life without dread. Of course, nothing is without a price. None of these "extracurricular activities" are paid. Fortunately, my office is doing well enough that I have not had to bear a pay cut, but I'm certainly not getting a raise anytime soon. But even so, despite being the primary wage earner in my family, it is worth it-to me, my husband, and my sons. I've said, "I had a great day!" more in the past year than I had in the preceding 5 put together. That alone is priceless.